Provider Demographics
NPI:1558412411
Name:FITZPATRICK, JULIA HEATHER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:HEATHER
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-4420
Mailing Address - Country:US
Mailing Address - Phone:866-284-2771
Mailing Address - Fax:619-435-4501
Practice Address - Street 1:158 C AVENUE
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-3114
Practice Address - Country:US
Practice Address - Phone:619-602-4598
Practice Address - Fax:619-435-4501
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 289291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical